Background: Early Laparoscopic Cholecystectomy (LC) is increasingly recommended for acute calculous cholecystitis; however, delayed surgery remains common because of concerns regarding operative difficulty and perioperative complications. Objective: To compare the operative, postoperative and healthcare outcomes of early versus delayed LC in patients with Grade I–II acute calculous cholecystitis. Methods: This prospective, non-randomized comparative cohort study was conducted at Al-Kindi Teaching Hospital, Baghdad, Iraq, from 1 March 2024 to 10 June 2025. A total of 120 adults were allocated according to surgical timing: 60 underwent early LC within 72 hours of hospital presentation and 60 underwent delayed LC 6–8 weeks after conservative treatment. The primary outcome was cumulative hospital length of stay. Secondary outcomes included operative duration, conversion to open surgery, postoperative morbidity, interval biliary events, treatment cost and return to usual activities. Results: Baseline demographic, clinical, laboratory and ultrasonographic characteristics were comparable between the groups. Early LC was associated with a longer operative duration than delayed LC (78.4±20.6 versus 69.2±18.5 minutes; p = 0.011) and more frequent gallbladder decompression (31.7% versus 13.3%; p = 0.016). However, conversion to open surgery (6.7% versus 5.0%; p = 1.000) and overall postoperative morbidity (10.0% versus 8.3%; p = 0.752) were comparable. Early LC significantly reduced total hospital stay (3.2±1.1 versus 7.1±2.0 days), direct treatment cost (US$1,140±250 versus US$1,510±330) and time to return to usual activities (10.8±3.4 versus 18.6±5.2 days; all p<0.001). Ten patients awaiting delayed surgery (16.7%) required unplanned readmission, including two who underwent urgent LC. No major bile duct injury, reoperation, or 30-day mortality occurred. Multivariable analysis showed that Grade II disease and difficult dissection, but not early surgical timing, independently predicted conversion. Conclusion: Early LC provided definitive treatment during the index admission, reduced cumulative hospitalization, cost and recovery time and prevented interval biliary events without increasing conversion or postoperative morbidity. Early LC should be preferred for suitable patients with Grade I–II acute calculous cholecystitis when experienced laparoscopic services are available.

Coronary Artery Disease (CAD) remains one of the leading causes of morbidity and mortality around the world and constitutes a major public health problem. The condition is associated with both non-modifiable factors like age, gender and genetics and modifiable ones like hypertension, diabetes mellitus, dyslipidemia, obesity, smoking and physical inactivity. Nowadays, greater emphasis is placed on primordial prevention that is related to the avoidance of the occurrence of the above-mentioned risk factors. The goal of the current review is to emphasize the significance of primordial prevention in relation to CAD. Evidence proves that atherosclerosis develops early in life and in a progressive manner due to the accumulation of unhealthy behaviors throughout life. As a result, it is highly important to intervene at the earliest possible stage. Development of healthy habits like proper nutrition, regular exercise, weight management, quitting smoking and stress management may considerably lower the probability of having cardiovascular risk factors. Besides, the social and environmental determinants such as education and socioeconomic status as well as accessibility to healthcare services are of great importance.